中国当代医药
中國噹代醫藥
중국당대의약
China Modern Medicine
2015年
26期
42-45
,共4页
非小细胞肺癌%放射治疗%调强放疗%剂量学
非小細胞肺癌%放射治療%調彊放療%劑量學
비소세포폐암%방사치료%조강방료%제량학
Non-small cell lung cancer%Radiotherapy%Intensity-modulated radiotherapy%Dosimetric
目的：比较老年局晚期非小细胞肺癌(LA-NSCLC)患者采取同期推量调强放疗(SIB-IMRT)与序贯推量调强放疗(SEQ-IMRT)的效果。方法回顾性分析徐州医学院附属医院2010年1月~2014年10月住院的56例老年LA-NSCLC患者,随机分为治疗组(28例,采用SIB-IMRT)和对照组(28例,采用SEQ-IMRT)。比较两组患者放疗计划不同参数的剂量及两组患者的近期疗效和急性毒副反应。结果 SIB-IMRT组肿瘤靶区内生物等效剂量(BED)(95.3依4.7)Gy高于SEQ-IMRT组的(86.4依3.2)Gy,差异有统计学意义(P<0.05)；SIB-IMRT组和SEQ-IMRT组的靶区适形指数分别为(81.8依1.3)%和(80.2依1.8)%,两组比较差异无统计学意义(P>0.05)；两组靶区肺受照相关体积、肺平均受照剂量、脊髓受照最大剂量、心脏受照相关体积比较,差异无统计学意义(P>0.05)。治疗组总有效率(CR+PR)为82.1豫,对照组总有效率为46.4豫,两组比较差异有统计学意义(P<0.05)。两组患者均未发生芋级以上的毒副反应,发生Ⅰ~Ⅱ级放射性肺损伤、放射性食管炎、急性骨髓抑制比较差异无统计学意义(P跃0.05)。结论 SIB-IMRT与SEQ-IMRT治疗老年LA-NSCLC,前者可获得理想的剂量分布,可提高肿瘤靶区内的BED且未增加周围危及器官剂量,可提高近期疗效且急性毒副反应无增加。
目的：比較老年跼晚期非小細胞肺癌(LA-NSCLC)患者採取同期推量調彊放療(SIB-IMRT)與序貫推量調彊放療(SEQ-IMRT)的效果。方法迴顧性分析徐州醫學院附屬醫院2010年1月~2014年10月住院的56例老年LA-NSCLC患者,隨機分為治療組(28例,採用SIB-IMRT)和對照組(28例,採用SEQ-IMRT)。比較兩組患者放療計劃不同參數的劑量及兩組患者的近期療效和急性毒副反應。結果 SIB-IMRT組腫瘤靶區內生物等效劑量(BED)(95.3依4.7)Gy高于SEQ-IMRT組的(86.4依3.2)Gy,差異有統計學意義(P<0.05)；SIB-IMRT組和SEQ-IMRT組的靶區適形指數分彆為(81.8依1.3)%和(80.2依1.8)%,兩組比較差異無統計學意義(P>0.05)；兩組靶區肺受照相關體積、肺平均受照劑量、脊髓受照最大劑量、心髒受照相關體積比較,差異無統計學意義(P>0.05)。治療組總有效率(CR+PR)為82.1豫,對照組總有效率為46.4豫,兩組比較差異有統計學意義(P<0.05)。兩組患者均未髮生芋級以上的毒副反應,髮生Ⅰ~Ⅱ級放射性肺損傷、放射性食管炎、急性骨髓抑製比較差異無統計學意義(P躍0.05)。結論 SIB-IMRT與SEQ-IMRT治療老年LA-NSCLC,前者可穫得理想的劑量分佈,可提高腫瘤靶區內的BED且未增加週圍危及器官劑量,可提高近期療效且急性毒副反應無增加。
목적：비교노년국만기비소세포폐암(LA-NSCLC)환자채취동기추량조강방료(SIB-IMRT)여서관추량조강방료(SEQ-IMRT)적효과。방법회고성분석서주의학원부속의원2010년1월~2014년10월주원적56례노년LA-NSCLC환자,수궤분위치료조(28례,채용SIB-IMRT)화대조조(28례,채용SEQ-IMRT)。비교량조환자방료계화불동삼수적제량급량조환자적근기료효화급성독부반응。결과 SIB-IMRT조종류파구내생물등효제량(BED)(95.3의4.7)Gy고우SEQ-IMRT조적(86.4의3.2)Gy,차이유통계학의의(P<0.05)；SIB-IMRT조화SEQ-IMRT조적파구괄형지수분별위(81.8의1.3)%화(80.2의1.8)%,량조비교차이무통계학의의(P>0.05)；량조파구폐수조상관체적、폐평균수조제량、척수수조최대제량、심장수조상관체적비교,차이무통계학의의(P>0.05)。치료조총유효솔(CR+PR)위82.1예,대조조총유효솔위46.4예,량조비교차이유통계학의의(P<0.05)。량조환자균미발생우급이상적독부반응,발생Ⅰ~Ⅱ급방사성폐손상、방사성식관염、급성골수억제비교차이무통계학의의(P약0.05)。결론 SIB-IMRT여SEQ-IMRT치료노년LA-NSCLC,전자가획득이상적제량분포,가제고종류파구내적BED차미증가주위위급기관제량,가제고근기료효차급성독부반응무증가。
Objective To compare the radiotherapy effect between SIB-IMRT and SEQ-IMRT in treating elderly pa-tients with locally advanced non-small cell lung cancer (LA-NSCLC). Methods 56 Patients with LA-NSCLC from Jan-uary 2010 to October 2014 in our hospital were retrospectively analyzed.Patients were randomly divided into treatment group (n=28) and control group (n=28).The control group were given SEQ-IMRT and the treatment group were given SIB-IMRT.Then the dosimetry of different parameters in radiotherapy plans,efficacy and acute toxicities between two groups was compared respectively. Results The BED of tumor target zone in treatment group was (95.3±4.7)Gy,signifi-cantly higher than that of (86.4±3.2)Gy in control group,and the difference was statistically significant (P<0.05).The CI between two groups was (81.8±1.3)% and (80.2±1.8)%respectively,and the difference had no statistically significant(P>0.05).There were no statistically significant between two groups in target illuminated lung volume,mean lung dose,the maximum dose of spinal cord illuminated and heart illuminated volume (P>0.05).The total efficacy rate was 82.1% in treatment group and 46.4% in control group,the difference was statistically significant (P<0.05).There were no adverse reaction more thanⅡ magnitude occured,and all of Ⅰ to II magnitude adverse reaction such as radioactive lung reac-tion,radioactive esophagitis,acute bone marrow suppression had no statistically significant between two groups (P>0.05). Conclusion Comparing SIB-IMRT with SEQ IMRT in treating elderly LA-NSCLC,the former can obtain ideal dose dis-tribution,increase the BED of tumor target zone,increase in the near future curative effect,but do not increase the sur-rounding organs threatening dose and acute toxicity.
